Healthcare Provider Details

I. General information

NPI: 1801889522
Provider Name (Legal Business Name): BAYOU ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 66TH ST
PINELLAS PARK FL
33781-5025
US

IV. Provider business mailing address

PO BOX 30130
TAMPA FL
33630-3130
US

V. Phone/Fax

Practice location:
  • Phone: 727-545-8454
  • Fax: 727-547-6983
Mailing address:
  • Phone: 800-919-1190
  • Fax: 706-860-7973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME53592
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME53592
License Number StateFL

VIII. Authorized Official

Name: DR. TODD STEVEN TRAUB
Title or Position: OWNER PRESIDENT
Credential: MD
Phone: 727-545-8454